Epidemic keratoconjunctivitis
Background
- Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
- Caused by adenovirus infection that is highly contagious and tends to occur in epidemics
Conjunctivitis Types
Clinical Features
- Ranges from subclinical conjunctivitis to severe disease with superimposed bacterial infection and systemic symptoms.[1]
- Can be preceded by prodrome of cough, fever, malaise, myalgias, nausea/vomiting
- Worsening foreign body sensation (starts near medial canthus and spreads laterally), followed by[1]:
- Lid swelling
- Tearing
- Itching
- Photophobia
- Blurred vision
- Conjunctival injection
- Papillae of inf palpebral conjunctiva
- Ipsilateral pre-auricular lymphadenopathy
- Slit lamp exam - diffuse, superficial keratitis but no corneal ulceration
Differential Diagnosis
Unilateral red eye
- Nontraumatic
- Acute angle-closure glaucoma^
- Anterior uveitis
- Conjunctivitis
- Corneal erosion
- Corneal ulcer^
- Endophthalmitis^
- Episcleritis
- Herpes zoster ophthalmicus
- Inflamed pinguecula
- Inflamed pterygium
- Keratoconjunctivitis
- Keratoconus
- Nontraumatic iritis
- Scleritis^
- Subconjunctival hemorrhage
- Orbital trauma
- Caustic keratoconjunctivitis^^
- Corneal abrasion, Corneal laceration
- Conjunctival hemorrhage
- Conjunctival laceration
- Globe rupture^
- Hemorrhagic chemosis
- Lens dislocation
- Ocular foreign body
- Posterior vitreous detachment
- Retinal detachment
- Retrobulbar hemorrhage
- Traumatic hyphema
- Traumatic iritis
- Traumatic mydriasis
- Traumatic optic neuropathy
- Vitreous detachment
- Vitreous hemorrhage
- Ultraviolet keratitis
^Emergent diagnoses
^^Critical diagnoses
Bilateral red eyes
- Painful
- Painless
Evaluation
- Clinical diagnosis
Management
- Artificial tears
- Cool compresses
- Cycloplegics if photophobia is severe
- Rigorous hand hygiene to prevent transmission
Disposition
- Discharge with rapid ophtho follow-up.
See Also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Meyer-Rüsenberg B, Loderstädt U, Richard G, Kaulfers P-M, Gesser C. Epidemic Keratoconjunctivitis: The Current Situation and Recommendations for Prevention and Treatment. Deutsches Ärzteblatt International. 2011;108(27):475-480. doi:10.3238/arztebl.2011.0475.
- ↑ Park SJ, Jang YS, Koh TH, Kwon YA, Song SW. Development of EKC after Eximer Laser Photorefractive Surgery and Subsequent Recurrence of EKC-like Keratitis. Korean Journal of Ophthalmology : KJO. 2011;25(6):443-446. doi:10.3341/kjo.2011.25.6.443.